Nokea
Tuberculosis responds well to long-term treatment with a combination of three or more antitubercular drugs. Which of the following is true regarding the duration of treatment for clients with tuberculosis? Select all that apply.
- A. The initial treatment phase should last for a minimum of 2 months.
- B. The initial treatment phase should last for a maximum of 2 months.
- C. The continuation treatment phase should last for 4 to 7 months.
- D. The continuation treatment phase should last for 6 to 12 months.
- E. Prophylactic treatment should be given for 6 to 9 months.
Correct Answer: A,C,E
Rationale: The Centers for Disease Control and Prevention recommends that treatment begin as soon as possible after diagnosis of TB and include the following: initial treatment phase lasting for a minimum of 2 months, continuation treatment phase lasting for 4 to 7 months, and prophylactic treatment given to family members of the infected individual for 6 to 7 months.
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A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs needs to be administered to the client?
- A. Pyrazinamide and dapsone
- B. Rifampin and pyrazinamide
- C. Rifampin and isoniazid
- D. Dapsone and isoniazid
Correct Answer: C
Rationale: The nurse knows that a combination of rifampin and isoniazid drugs should be used during the second phase of standard treatment. Isoniazid, rifampin, and pyrazinamide are not used together as combination drugs in the second phase of standard treatment. Dapsone is used for leprosy and cannot be used in combination with isoniazid or any other drug for TB.
A patient in the initial phase of TB is prescribed ethambutol. The nurse monitors the client for which of the following suggesting an adverse reaction?
- A. Hypersensitivity
- B. Skin eruptions
- C. Joint pain
- D. Myalgia
Correct Answer: C
Rationale: Joint pain is an adverse reaction of ethambutol. Hypersensitivity and skin eruptions are adverse reactions of isoniazid. Myalgia is an adverse reaction of pyrazinamide.
A nurse is preparing to teach a client about common adverse reactions associated with rifampin (Rifadin). Which of the following would the nurse include? Select all that apply.
- A. Discoloration of body fluids
- B. Vertigo
- C. Joint pain
- D. Nausea
- E. Rash
Correct Answer: A,B,D,E
Rationale: Common adverse reactions of rifampin include nausea, vomiting, epigastric distress, heartburn, fatigue, vertigo, rash, reddish-orange discoloration of body fluids, hematologic changes, and renal insufficiency.
Which of the following circumstances would warrant a continuation treatment phase of 7 months? Select all that apply.
- A. Noninclusion of rifampin in the initial treatment phase
- B. Noninclusion of pyrazinamide in the initial treatment phase
- C. HIV positive clients
- D. Cavitary disease after completion of initial treatment
- E. Positive sputum culture after completion of initial treatment
Correct Answer: B,E
Rationale: Noninclusion of pyrazinamide in the initial treatment phase, positive sputum culture after completion of initial treatment, and positive sputum culture after initial treatment in a client with previously diagnosed HIV infections would warrant a continuation of the treatment phase.
A nurse is developing a plan of care for a client receiving an antitubercular drug. Which nursing diagnosis would the nurse most likely include directly related to drug therapy? Select all that apply.
- A. Acute Pain
- B. Risk of Skin Integrity
- C. Imbalanced Nutrition
- D. Body Image Disturbances
- E. Risk for Ineffective Self Health Management
Correct Answer: A,C,E
Rationale: Drug administration-specific nursing diagnoses that may be made during treatment with antitubercular drugs include Acute Pain related to frequent injections, Imbalanced Nutrition due to gastric upset, and Risk for Ineffective Self Health Management related to indifference, lack of knowledge, and long-term treatment.